.png "A-A-vs-Va-(1).png")
When a veteran starts needing more help at home, one of the first questions families often ask is, “Will the VA pay for this?”
That is a great question, but the answer depends on which VA benefit you are talking about.
Two programs that often come up when families research care are Aid and Attendance (A&A;) and VA Community Care. While both can provide valuable support to eligible veterans, they work very differently.
Understanding the difference can help families figure out what type of help they should be asking about.
What Is VA Aid and Attendance?
Aid and Attendance is a VA pension benefit that provides an additional monthly payment to qualifying veterans and survivors who meet the eligibility requirements.
A veteran receiving a VA pension may qualify for Aid and Attendance if they need help from another person with everyday activities such as bathing, feeding, or dressing. Other qualifying situations can include being bedridden, living in a nursing home because of certain physical or mental limitations, or having qualifying severe vision impairment.
The important thing to understand is that Aid and Attendance is a financial benefit.
The veteran receives additional money through their VA pension. That money can then be used toward their care and other living expenses.
Aid and Attendance does not send a caregiver to the veteran's home. Instead, it provides financial assistance to a qualifying veteran or survivor.
What Is VA Community Care?
VA Community Care works differently.
Community Care allows eligible veterans to receive certain health care services from approved providers in their local community when the VA determines that community care is appropriate. VA can pay for authorized care provided through its community care network.
Community care can include home health care and other home-based services when those services are appropriate and authorized.
For example, an eligible veteran who needs help at home may receive services through programs such as Homemaker and Home Health Aide care. A trained caregiver can provide assistance with activities of daily living such as bathing, dressing, grooming, eating, using the bathroom, and moving around the home.
The VA also provides skilled home health services for veterans who need certain medical services at home, which can include nursing and therapy depending on the veteran's needs.
So What Is the Biggest Difference?
The easiest way to think about it is this:
Aid and Attendance provides money.
VA Community Care provides authorized health care services.
With Aid and Attendance, the veteran receives an increased monthly pension payment if they qualify.
With VA Community Care, the VA authorizes specific care through an eligible community provider.
These are not interchangeable programs, and qualifying for one does not automatically mean you qualify for the other.
Does Aid and Attendance Pay for In-Home Care?
It can help financially with the cost of care, but it is important to understand what that means.
Aid and Attendance is not a home care authorization. It is a monthly financial benefit that can help a qualifying veteran pay for expenses, including care.
This can make it a valuable option for veterans who need ongoing assistance but are not receiving VA-authorized home care through Community Care.
The eligibility requirements are also different from VA Community Care. Aid and Attendance is tied to VA pension eligibility and specific requirements for needing assistance or meeting another qualifying condition.
How Does VA Community Care Pay for Home Care?
VA Community Care is connected directly to the VA health care system.
Generally, a veteran must be enrolled in or eligible for VA health care and receive approval from their VA health care team before receiving care from a community provider, except for certain circumstances such as urgent or emergency care. The VA also considers factors such as whether the needed service is available through VA, access standards, and the veteran's individual circumstances.
For home-based services, the veteran's clinical needs are also important.
VA guidance for purchased Home and Community-Based Services includes veterans who need assistance with two or more activities of daily living, veterans with significant cognitive impairment, certain veterans receiving hospice-related personal care, or veterans whose clinical care team documents another justified need for the service.
That means the VA looks at the veteran's actual care needs rather than simply asking whether the person is a veteran.
What Does “Activities of Daily Living” Mean?
You may hear the term ADLs, or activities of daily living, when talking about VA home care.
ADLs are basic everyday activities that people normally need to do to care for themselves.
Examples include bathing, dressing, eating, grooming, using the bathroom, and moving from one place to another.
If a veteran is struggling with several of these activities, it is important to explain those difficulties clearly when speaking with the VA health care team.
For example, saying,“Mydad needs help at home” does not provide nearly as much information as explaining that he needs assistance getting into the shower, dressing himself, preparing meals, and transferring safely from his bed to a chair.
Those details help the care team understand the level of support he needs.
Can a Veteran Have Private Insurance or Medicare and Still Use VA Community Care?
Yes, potentially.
Being enrolled in VA health care does not automatically mean a veteran has to stop using every other source of health care.
A veteran can have Medicare or private health insurance and still potentially receive VA health care and VA-authorized community care, depending on their eligibility and circumstances.
The important distinction is that VA Community Care must go through the VA authorization process. A veteran generally cannot simply hire a community provider and expect the VA to pay afterward. VA authorization is required before community care is received in most non-emergency situations.
Which One Is Right for Your Loved One?
That depends on what kind of assistance the veteran needs.
If the primary need is financial assistance to help pay for care, Aid and Attendance may be worth exploring.
If the veteran needs actual health care or home-based services authorized through the VA, Community Care may be the more relevant program.
And in some situations, families may want to learn about both.
The important thing is not to assume that one VA benefit is the same as another. The eligibility requirements, application process, and way the benefit is delivered can be very different.
Where Can Veterans Get More Information?
If you are interested in Aid and Attendance, the VA provides information and application instructions through its official Aid and Attendance and Housebound benefits page. You can apply online, by mail, or in person.
For Community Care, veterans should start with their VA health care team and ask whether they qualify for community-based care. The VA also recommends speaking with a social worker or care team about home and community services that may be appropriate.
Veterans and families can also contact their local VA medical facility for assistance navigating available programs.
BrightStar Care of Roseville and Sacramento
At BrightStar Care of Roseville and Sacramento, we provide compassionate, reliable in-home care for medically fragile people of all ages, including veterans and their families.
Our services can include personal care assistance, help with activities of daily living, skilled nursing, therapy services, and other personalized support at home based on each person's individual needs.
If you are researching VA home care, Aid and Attendance, or VA Community Care and are unsure where to begin, our team can discuss your caregiving needs and help you understand what type of care you are looking for.
BrightStar Care provides home care services throughout Placer County, Sacramento County, and surrounding areas.
Call BrightStar Care of Roseville and Sacramento at 916-781-6500 to discuss your caregiving needs and learn more about in-home care options for yourself or your loved one.
